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Modified Anterior Z Le Fort III Osteotomy.

Garcia Y Sánchez Jose Manuel1, D A Valdes Martínez2, Lopez Bonilla Salvador3

  • 1Maxillofacial Surgery Department, Medical Specialities Hospital, Centro Medico Nacional Century XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico.

Journal of Maxillofacial and Oral Surgery
|January 27, 2023
PubMed
Summary

The Modified Anterior Z Le Fort III Osteotomy (MAZLFIIIO) effectively corrects midface deficiencies without grafts. This technique improves patient appearance and protects the eyes, offering a predictable solution for maxillo-malar hypoplasia.

Keywords:
3d stereolithographic modelMidface deficiencyModified Anterior Z Le Fort III osteotomy

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Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Orthognathic Surgery

Background:

  • Maxillo-malar hypoplasia presents significant aesthetic and functional challenges.
  • Current surgical techniques for midface hypoplasia are varied and require careful patient selection.
  • Le Fort I osteotomies alone can result in an undesirable step deformity in the midface.

Purpose of the Study:

  • To describe the Modified Anterior Z Le Fort III Osteotomy (MAZLFIIIO) technique for correcting posteroanterior midface deficiency.
  • To evaluate the efficacy of MAZLFIIIO in improving facial aesthetics and orbital protection.
  • To present MAZLFIIIO as a predictable alternative to grafts or distraction osteogenesis for midface advancement.

Main Methods:

  • The MAZLFIIIO technique was performed in seven non-syndromic patients between 2016 and 2018.
  • Surgical planning involved stereolithographic models and custom Z-shaped surgical splints.
  • The technique allows for midface advancement without bone grafts or distraction, with measurements based on orbital structures.

Main Results:

  • The MAZLFIIIO procedure resulted in notable improvements in patient appearance.
  • The technique provided enhanced protection for the lower orbital region.
  • Widening of the maxillary sinus was observed as a concurrent benefit.

Conclusions:

  • MAZLFIIIO is a predictable and effective osteotomy for correcting specific midface deficiencies.
  • The technique addresses limitations of traditional Le Fort I osteotomies by avoiding step deformities.
  • MAZLFIIIO is presented as a valuable, combined, and routine procedure in midface surgery for maxillo-malar hypoplasia.